For most people, preparing for an exam involves learning the material tested in the exam. After doing so, they feel that is enough for them to do well in the examination. For most short quizzes and even shelf exams, that is usually enough. But for examinations like the USMLE, it calls for a different, more thorough approach.
There are people who can study for the USMLE the same way they have always studied and do well. The main reason is that these people already have good study habits and skills which they just carry on into their USMLE prep. They usually do very well in medical school due to these same skills. However, study habits and skills good enough for medical school will be inadequate because of the unique requirements of the USMLE.
The USMLE is different from all other exams for the following reasons
- It’s coverage is very broad.
- It’s a very long exam.
- It’s a very clinical exam.
- It’s a time-pressured exam.
- It’s all or nothing
Let’s go over them in detail
The USMLE has Very Broad Coverage
Unlike most examinations we commonly encounter in medical school including shelf exams, the USMLE covers a lot of materials. For example, when you have a shelf exam for anatomy, you only need to remember anatomy until you finished the exam. Then you can start forgetting it while you prepare for the Physiology shelf exam.
In the USMLE Step 1, you need to know all 7 subjects at the same time and you need to be able to retain and recall all that information on the day of the examination. Therefore, it requires additional preparation in order to do well compared to the usual exams we encountered before.
The USMLE is a Very Long Exam
The USMLE Step 1 is 7 hours long with a 1 hour break totalling 8 hours. The USMLE Step 2 CK is 8 hours long with a 1-hour break totalling 9 hours. USMLE Step 3 covers 2 whole days. The most important problem you need to address here is fatigue. Believe me, by the time you hit the 5th block, your head refuses to work. You need to reread questions. You can’t think straight and it takes longer just to think of the answer.
The USMLE is a Very Clinical Exam
Lately, the USMLE has become more and more clinical, with over 50% of the questions in Clinical Vignette format. This adds a level of complexity to the exam which can impact negatively anyone unprepared for it. Therefore there is a need to make sure you can diagnose clinical cases even in USMLE Step 1 which is primarily Basic Sciences.
The USMLE is a Time Pressured Exam
The questions are long and you need to analyze the questions well before you can answer them. A lot of the questions require two to three step thinking which lengthens the amount of time you need to answer the questions properly. Therefore one of the biggest problems examinees have is finishing the exam within the time period provided. There is a need to take this into account during your USMLE prep and not just during the exam
The USMLE is All or Nothing
For the purpose of the USMLE, if you cannot answer the question, usually in about a minute, then you do not know it. It does not care if you forgot it. It does not care if you can’t just recall it. It does not care if you run out of time. If you can’t answer it, you don’t know it and you don’t get partial points. In medical school, we are used to being graded over our performance for the full semester or year. The USMLE does not care how much time you spent studying, how many sleepless nights you have gone through, nor how may questions you have practiced on. If you can’t answer it, you don’t know it. So again, there is a need to study a certain way to ensure you can answer those questions when the time comes.
We will continue discussion of the three phases of USMLE Prep on future posts.